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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License
e6#l1 e •� yyLiy�c.. r�Class Exp. Date �o
ev
Date { :!Signature of Contractor" XA--4—' ' `*-•d ti .A .'
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the ,project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code,; for the
performance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier y, p�, `r J11�a Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions 11.10
Date: . ✓.;:. ,-• �Applicant
- .sr --
Warning: Failure to secure Wo* s' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees
2. Any permit issued as a result of this application becomes null and void i
work is not commenced within 180 days from date of issuance of suc
permit, or cessation of work for 180 days will subject permit to cancellation
I certify that I have read this application and state that the above information i
correct. I agree to comply with all City, and State laws relating to the buildin
construction,, and hereby authorize representatives of this City to enter: upon
the above-mentioned,property for inspection purposes.
Signature (Owner/Agent)';ii'!Y, �•A'i ti -Z* ; Agg DateF •�'
PORCi•1M- rA10 ;4305m,, S.F
Q&RA0E1CARFQT,'T D51,10 SF
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:'i•,�d?�:���r!
BUILDING PERMIT
PERMIT#
A}
DATE VALUATION ¢v.�d�ry �q s Lp4 LOT
(•^ .� '+puh'+3�J.((r:.r�'7a
4' TRACT t
1itj �S��iptl
f .. l
JOB SITE
X 11-(.`n^ ,9•�1 is
APN
ADDRESS :3-0 EL G^s'f•'�•.i•`O M
•4
FEE ;DT"f°OWT-(1�y
770 31 MI. x01A
OWNER
CONTRACTOR/DESIGNER/EN INEER
1?FTIr r & a'C9pis, �.'�/ •y +•rry!•� y
. t,7 dx��JVI)l /iV
q� A �� 'T •4t. �q �,y
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F%EC 1 MAL TME
101 ! 000-#20—U0,r
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101.004.419-0.0 1
USE OF PERMIT
111TK• X FAMILY iD�Il�'LLD_ RG
v�`?tC;+r1Ck �t�TiC�i�t �!�:� •• �'�i�?
SMVXC:L'UDi.:S C.OMPLLAldCL?WITIN
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dyCT C it3731FAP'PLAC,A.D1.,L IS IUJR. -0
OIrAP.1140 FIG
PORCi•1M- rA10 ;4305m,, S.F
Q&RA0E1CARFQT,'T D51,10 SF
Y�Ai�l!'�:�> ��`t0�`e�" iJe�° i:;�iJ1V�'T,.i�'tSsG°'(;�if�
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COA1STRUC I -ON, FFM ..
10 1 -0010.418,00 t
0165IJ4 '
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OIrAP.1140 FIG
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.
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I�'7.1. Li
Isa8.63
Aa
i4:+' :��1, P. Mii.P O DIAD NOW
JUN 17 2003.;
CITY OF LA QUINTA :
FINANCE DEPT:. � ,;; v
RECEIPT DATE BY DAT FINAL D INSPEC OR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Q
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
,0 3
Exhaust Fans
O.K to Wrap
Z G
F.A.U.'
Framing
Compressor
Insulation
Q
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
. Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
— U
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
_Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole i
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures'
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power.
Final
Utility Notice (Perm) p
COMMENTS:
u�it,�Cv
P.O. BOX 1504
Building -5'-3- �D 78-495 CALLE TAMPICO APPLICATION ONLY
Address LA QUINTA, CALIFORNIA 92253
Owner
L fit ►'moo�tL
Mailing BUILDING: TYPE-CONST.V OCC.GRP.
Address
A.P. Number 7-7c,j. I u o
City Zip Tel. � _
Legal Description �..�-- 4—�L .�
Contractor Project Description
Address��
CityJ
Zip Tei,
State Lic. City
& Classif. L€c. # Sq. Ft�1j1 No. No. Dw, r
Arch., Engr., Size Stories Units
Designer (J i WV,40-> e --P— New Add ❑ Alter ❑ Repair ❑ Demolition ❑
A00cess" Tel.
t �7 "' /
City Ip Stat#
LICENS CONTRACTOR'S DECLARATION
f heals • f([rm rhes I am Ilcen d under crovlslor. of Chaplet 9 (commencing ith sectfdn
7 Af Ivi 3 of th usi sand Prclessicnde, i�ba/ I Elm r� RyyQ
off f T L
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt Irom the Contractor's License Law for th6 lollowing
reabpn: (SeC 7031.5.9uskrass and Prafassrom Coda; Any city or county wNch reoutres a
Permit Io consuucf, allot• improve, demolfsh, at repair any structure, prior Io its issuance also
raglar9a the appA'canf for such permif In fila a Signed 5lafamen! that he is ri ansed pursuant to
rhe era vrsians of the Confracfar's License Law, Chapter s (commencing will, Section 7000) 01
In"'s0on 3 at the Ausrne55 and FrOfaySldni Cade, Of fhaf ha is Oxampt therefrom, and the ba'is
of the alleged exemplian. Any viofation OfSection 7031.5 by any aap ficanl !or a permit
subfecla the applicant i0 a civet panalry or flat mare (hen firm hundred dollars fS500J.
i, as owner at the property, or my emptoyaee wflh wages as their sole compensation, wilt
do the work, and the structure Is not IntOnded ar offered for sale- fSac. 70444 Bvisness and
Processions Coda The Coniraclw's home Law does not apply to an cwnar of property who
burlds or xrrpfaves rheracp and who One$ tach work nimsarr of through his awn employees,
provided in4l .ouch rmprewamenls are nor Intended or offered for sale. if, hower9e, the building
or mipfoi—enc is good within one year of comptetlOn, the owner-fIU4dee will have the burden
of pip—ir mat he did nal build Of Improve for the Pufpose of sale-)
I i f, as owner al the propelly, am exclusively contracting with licensed contractors to can-
Situcl the project. fSec 7044, El siness and Professions Code: The Contractor's Lkense Law
does not apply to an owner or property who buifdt or tmpedvas (hereon, and who contracts for
such prplecls with a contractorrs) licensed pursuant to the Contractor's License Law•J
i l I am exempt under Sec._ B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insur, m:e, are certified copy thereof. (Sec. 3800, Labor Code,)
Policy No" -Company _
Copy is filed with the city ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
Or less.)
I cattily thal in the performance of thg work for which this permit is issued, I shall not
em Play any person in any manner so as to become subject to the Workers' Compertaslion
Laws of California.
Date_ Owner _
NOTICE TO APPLICANT: ff. after making fiiis CeRi!rcale Of Exemption you should become
subject to the Workers' CoRWnsalion provisions of the Labor Cnew you must forthwith
comply veith such provisions or this permit shall be deemed revoked
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec 3097, Civil Code.)
Lender's Name—
Lender's Address
This is a building permll when= filled but, signed and validated, and is subject Io
expiration If work thereunder is suspended for 180 days"
I certify Ifial I have road this appilcatlon and state that the above Information Is conedt.
I agree 10 comply wlln all city and county ordinances and state laws totaling to building
c0nslruciipn, and heieby authorize representotives -of this city to enler the above,
mentioned propen y for ins pea Iion purposes"
Signature of
Mailing Add+
City, State,
valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I_
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line_
Rear Setbacl #.ram Rear .�r0p, Line,
Side Street. Setback1t oni Center= Li
Side Setback,(rom Property tine
FINAL DATE `INSPFf T[3L��y
Issued by:
Validated by:
Validation:
WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANr:F
AMOUNT
oma
Lity of La Quinta, Building & Safety _j,epartment
RESIDENTIAL PLAN CHECK CORRECTION LIST (os)
DATE: March 26, 2003 ADDRESS: 53-600 Del Gato Drive
/ STATUS: First Review DESCRIPTION: 4354 sq.ft. SFD
PLAN CHECKED BY: Burt Hanada
TELEPHONE NUMBER: (760) 777-7023
APPLICANT: ANDRZEJ W. WEBER
PLAN CHECK #: 0302-219
This submittal has been checked for compliance with the 2001 California Building, Mechanical, Electrical, and
Plumbing Codes (CBC, CMC, CEC, and CPC, respectively), the 2001 California Energy Code and the City of La
Quinta Municipal Code.
APPLICANT: BUILDING DEPARTMENT STAFF:
The following items are being returned to you for DO NOT accept any resubmittal unless ALL of the
correction: following items are included:
2 Sets — Redlined Plans 2 Sets — Redlined Plans
2 Sets — Structural Calculations 2 Sets — Revised Plans
2 Sets — Energy Calculations 2 Sets — Structural Calculations
This Correction List 2 Sets — Revised Structural Calculations
2 Sets — Truss Calculations
1 Truss Acceptance Letter from Engineer of Record
2 Sets — Energy Calculations
This Correction List with Written Responses
INSTRUCTIONS TO APPLICANT:
1) Provide a written response to each comment on the following pages, noting specifically where the correction
can be found. Responses such as, "Sheet A-3," or, "Handrails shall be per CBC Section 1003," are not
acceptable. Show or note specifically how compliance with a code requirement is achieved. Responses
such as, "Added note 16 on sheet A-3" are appropriate and will help expedite your back check.
2) Corrections may not be made by handwriting on existing drawings. Revise originals and reprint Plans and/or
Calculations as necessary.
3) Return all red -marked Plans and/or Calculations with your resubmittal.
4) Each sheet of resubmitted Plans and/or Calculations shall include the preparer's name and telephone number
and shall be wet -signed by the preparer. If the preparer is a licensed architect or engineer, all documents
prepared by that licensed individual shall also bear his/her stamp as prescribed by California Business and
Professions Code 05536. Resubmittals will not be accepted with signatures missing.
5) Return this list, your written responses, and all documents listed above with your resubmittal.
Residential Plan Check Correction List Page 1 of 8
City of La Quinta, Buildin, 1Safety Department
SECTION A - GENERAL
1) Provide the Project Address on the first sheet of Plans. Revise address on cover sheet to 53-600 Del Gato
Drive.
2) Provide on each sheet of resubmitted Plans and cover sheet of bound Calculations the preparer's name and
telephone number and wet -signature. If the preparer is a licensed architect or engineer, all documents prepared
by that licensed individual shall also bear his/her stamp as prescribed by California Business and Professions
Code 05536. Resubmittals will not be accepted with signatures missing.
3) Note on Plans: "All construction shall comply with the 2001 California Building, Plumbing, Mechanical,
Electrical, and Energy Codes and all other local codes and ordinances." Remove notes referencing other Code
Sections as redlined on Sheet 15.
4) Note on Plans: "All `or equal' substitutions must be submitted to, and approved by the Building Official prior
to installation of the item."
5) Provide a current paper copy of the following ICBO Evaluation Report(s):
6) Provide current ICBO Evaluation Report Numbers for the following item(s):
7) Provide detailed information on the Site Plan noting the location of the 150 foot setback from Avenida
Bermudas which restricts residences to a maximum 17 feet height [L.Q. City Council Resolution No. 98-17,
97-028].
SECTION B — PRECISE / SITE PLAN / ZONING
1) Provide a complete Site Plan showing north arrow, property lines and lot dimensions, location of existing curbs
(or edge of street paving if no curbs exist), all existing and proposed structures, setback dimensions, utility
locations, and (if utilized) location of private sewage disposal system. (CBC § 106.3.3)
2) Show on Site Plan how lot will drain to the Right -of -Way with a minimum slope of 1 %. (CBC Appendix
§3315.4)
3) Specify on Site Plan the Finish Floor and Pad Elevations. Pad Elevation shall match the Approved Pad
Elevation on file with La Quinta Public Works Department. Approved pad Elevation is 154.0.
4) Provide and incorporate into the Plans an engineered Grading Plan showing:
a) Grade elevations for all adjacent properties and the street
b) Proper drainage of this lot
c) All retaining conditions
5) Show on Elevations the height of this structure as measured from finish grade, demonstrating compliance with
LQMC Chapter 9.50.
6) Show roof -mounted equipment as hidden lines on Elevation Drawings and as object (solid) lines in Section
Drawings and on Roof Plan. Provide details for screening of equipment in accordance with LQMC
§9.60.140.B if parapet wall is not higher than the highest point of the equipment.
7) Show the location of automatically illuminated building address numbers, clearly visible from the street or
Residential Plan Check Correction List Page 2 of 8
Type Single Family Residence No. of Units 1
Lot # No. Street S.F.
Unit 1 103 53600 Del Gato Drive 4354 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 4,354 S.F. or $9,317.56 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage. in this proposed project may now be issued.
Fees Paid By CC/Palm Desert National Bank - David Larson Check No. 087566
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon McGilvrey $9,317.56 So.00
Payment Recd Over/Under
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
DATE:
16 April 2003
TO: Community Development Department
City of La Quinta,
78495 Calle Tampico, La Quinta, California 92253
FROM: ANDRZEJ W. WEBER
LETTER OF TRANSMITTAL
RE: Mr. & Mrs. Philip Branson Proposed Residence
53600 Del Gato Drive, La Quinta, California
Gentlemen, <1
While designing the Residence for Mr. & Mrs. Philip Branson on lot #103 on Del Gato
Drive in Tradition Community the project team was not aware of the additional height
limit restriction that was imposed by the City of La Quinta on every lot on the Del Gato
Drive adjacent to the Avenida Bermudas. It requires adjustment of the height limit from
22 feet elsewhere to 17 feet within 150 feet east from the Avenida Bermudas right-of-
way.
The condition was brought to our attention by City of La Quinta Building Department
during the plan check process. As it turned out the main body of the planned residence
within the affected part of the lot, confirms to the height restriction with the exception of
two towers. The tower closer to the street falls 100% within the lowered height area with %
the footprint of 9-6 * 9-6 feet (90 sq.ft.) and roof at the ridge reaching 19'-2" above the ,
approved pad elevation. The second tower, the entry, roughly 75% within the lowered
height area, with the footprint of 15-9 * 15-9 feet (90 sq.ft.) and roof at the ridge
reaching 22'-0" above the approved pad elevation. The survey shows that the top of the
curb of Del Gato Drive at the lot 103 (151.21 feet) is over ten (10) feet below the
Avenida Bermudas top of curb (161.64 feet at the lowest point), thus restricting the
visual impact height adjustment variance, if granted, -would have`on the view lines of
homes on the west side of the Avenida Bermudas! The proposed residence highest rooid
point (the entry tower) would be than well below the 17 feet limit when viewed from the '
Avenida Bermudas, as shown on the attached graphic'exhibit prepared by my office and
based on the civil engineer's field measurements.
Or. & Mrs. Phil Branson
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53_ Certificate ofOccupancyLal
4
Building & Safety Department
OF T
600 -
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was ' in compliance with the
provisions of the . Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 53-600 DEL GATO
Use classification: SFD Building Permit No.: 0302-219
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: PHILIP&SUSAN BRANSON Address:
By: KIRK KIRKLAND
Date: 6-8-04
Building Offic#61
POST IN A CONSPICUOUS PLACE
W